Bilateral distal tibial stress fractures in a military recruit

Stress fractures are common injuries in athletes and military recruits. They result from repetitive microtrauma, which over time exceeds the bone's intrinsic ability to repair itself. The site of occurrence is most commonly the weight-bearing lower limb. Such injuries are easily missed as the history and clinical signs are often not consistent with an acute injury and therefore may not warrant an x-ray on first presentation to the emergency department or primary care. Even when plain radiographs are taken, the fractures may not be initially evident and in the presence of a high index of clinical suspicion, further investigations may be necessary. We present the case of a military recruit who developed bilateral distal tibial stress fractures early on in his training.